Ercall Road Care Home Service 2 & 2a Ercall Road Brightons Falkirk FK2 0RS Telephone: 01324 717994 Type of inspection: Unannounced Inspection completed on: 20 July 2016 Service provided by: Forth Valley NHS Board Service provider number: SP2003002712 Care service number: CS2003011562
About the service Ercall Road is a care home providing care and support for up to 13 adults with learning disabilities. It is owned and managed by NHS Forth Valley. Nine people lived there at the time of the inspection. There were no plans to increase the numbers of service users from nine. The service is made up of two separate houses next to each other with their own front doors but with a shared garden. Each house has a lounge, dining room, kitchen and utility room. All the bedrooms are single but bathrooms are shared. The large, enclosed rear garden is very pleasant. The service is in a quiet residential area at the top of a steep hill but it is close to shops and amenities. Public transport is easily available. What people told us Comments by service users who filled in Care Inspectorate questionnaires included: ''I didn't know I could choose my key worker. I would like to be more independent with minimal staff support.'' ; ''I didn't know about complaining. I only sometimes have a say in how the service is run.'' We did feed these comments back to the managers. We had noted some service users had had help from staff to complete the questionnaires. We suggested staff try to fill in any comments as closely to the exact words of service users as they can. The service had recently and helpfully done a local service user satisfaction survey. Some comments included: ''I get on well with everyone. We have a laugh and kid each other on.''; ''I feel okay talking about my worries.''; ''The manager talks to me and explains things.''; ''She's a good manager.''; ''If anything is bugging me I can bring it up at the meeting.''; ''Staff are good at advising me of places to go out.'' ''I feel safe. Staff do a good job.'' Service users' comments to the inspector during the inspection included: ''The manager says if I have any problems I can speak to her. Staff are very good. We have a wee blether if I'm worried about anything.''; ''I like living here.'' Self assessment The self assessment was comprehensive, relevant and helpful. From this inspection we graded this service as: Quality of care and support Quality of environment Quality of staffing Quality of management and leadership 5 - Very Good not assessed not assessed 5 - Very Good page 2 of 7
What the service does well Staff concentrated on the needs and wellbeing of service users at meal times. Staff and service users ate together. Staff supported service users to be involved in food preparation; to be independent whilst preparing food and having their meals. The atmosphere at the communal table was calm, warm and relaxed. The experience for service users in preparing food and enjoying meals was very good. The service had taken on board our comments in the previous inspection that the quality of food could be improved. The manager had written a report on the standards of menu planning. One house was assessed by the manager as doing better than the other. She fed this back to staff at a team meeting. Plans were made to improve. This showed a commitment to improving quality that will benefit service users. The service continued consistently to have the highest standards of care planning, risk assessment, review and recording. Service user records were very carefully kept and well presented. They would be easy to read by service users and families, containing many up to date photos and mementos of events. Health matters including appointments were very clearly flagged up and kept. Service users and families could be confident that their needs and aspirations would be paid proper attention. There was a strong sense and value base of commitment to the wellbeing of service users as unique individuals. Taking our advice from a previous inspection report, the service had done a local service user satisfaction survey. This showed a commitment to find out about what service users think. The results were very positive e.g. ''I love where I live.'' All said they had an annual review and agreed they felt safe. Systematic audits of day to day quality control were being introduced. Various regular checks and auditing were already being done carefully, with plans to extend. This showed an understanding about the importance of safety and standards of care and support. That leads to a safe quality of life for service users. Staff morale was high. One said: ''I go home and think, that was a great day.'' We gave staff we interviewed very positive feedback about their understanding, attitudes and applied values. We saw reflective discussion, cooperation and respect at the team meeting. Staff regarded managers as open and approachable. Training was of a good, comprehensive standard. Staff were able to sustain consistent service user support enabling a good mix of security and independence. What the service could do better The manager recognised the need for the standard of menu planning and the quality of food to improve. The manager's own audit suggested one of the two houses could learn from the other regarding planning, variety and recording of food served for example: what fresh food was included. We suggested the service consider having a staff nutrition champion, perhaps from the better performing house. A volunteer service user could be involved as a partner in the plan too. This initiative could improve quality of life. We discussed the use of language with managers. NHS Forth Valley official documents use the terms 'challenging behaviour' and 'violence and aggression'. Care Inspectorate now use 'stress and distress' to describe such behaviours. This description is more respectful and understanding of the causes of actions. We suggested managers discuss this issue with their organisation. page 3 of 7
We noted that we had not had reports on all recent incidents of medication administration errors or omissions (with the potential to cause harm to a service user). We also discussed with the managers, the following: one person's medication was insecurely stored. We have made a recommendation about this. See recommendation one. Ensuring this is implemented will further enhance service user safety. Support workers, who were key workers, did not routinely draw up risk assessments or care plans or write review minutes. This was done by more senior staff. This practice was now leading to possible issues with support staff undertaking SVQ3 as opposed to SVQ2. As one Ercall Road staff member who was awarded an SVQ3 whilst in a previous job told us: ''Having an SVQ3 gives you extra insight and makes you analyse and pick up on things more.'' We would encourage the service to consider supporting suitable staff to at least undertake first drafts of care plans etc. and to continue to support suitable staff to apply for SVQ3. More highly qualified staff are likely to lead to even better outcomes for service users. Requirements Number of requirements: 0 Recommendations Number of recommendations: 1 1. The service should report to the Care Inspectorate all instances of medication administration errors or omissions where there was potential to cause harm to service users. All medication should be kept safely and securely. This is to comply with National Care Standards NCS 15: Care Homes for People with Learning Disabilities - Keeping Well - Medication. Complaints There have been no complaints upheld since the last inspection. Details of any older upheld complaints are published at www.careinspectorate.com. page 4 of 7
Inspection and grading history Date Type Gradings 8 Jul 2015 Unannounced Care and support Management and leadership 4 - Good 2 Dec 2014 Unannounced Care and support 4 - Good Management and leadership 4 - Good 13 Oct 2014 Re-grade Care and support 2 - Weak Management and leadership 6 Nov 2013 Unannounced Care and support 6 - Excellent 6 - Excellent Management and leadership 14 Nov 2012 Unannounced Care and support 6 - Excellent Management and leadership 6 - Excellent 25 Nov 2010 Unannounced Care and support Management and leadership 11 Aug 2010 Announced Care and support Management and leadership page 5 of 7
Date Type Gradings 5 Jan 2010 Unannounced Care and support Management and leadership 16 Jun 2009 Announced Care and support Management and leadership 26 Jan 2009 Unannounced Care and support Management and leadership 8 Jul 2008 Announced Care and support 4 - Good Management and leadership 4 - Good page 6 of 7
To find out more This inspection report is published by the Care Inspectorate. You can download this report and others from our website. Care services in Scotland cannot operate unless they are registered with the Care Inspectorate. We inspect, award grades and help services to improve. We also investigate complaints about care services and can take action when things aren't good enough. Please get in touch with us if you would like more information or have any concerns about a care service. You can also read more about our work online at www.careinspectorate.com Contact us Care Inspectorate Compass House 11 Riverside Drive Dundee DD1 4NY enquiries@careinspectorate.com 0345 600 9527 Find us on Facebook Twitter: @careinspect Other languages and formats This report is available in other languages and formats on request. Tha am foillseachadh seo ri fhaighinn ann an cruthannan is cànain eile ma nithear iarrtas. page 7 of 7